Walmer Lodge Residential Home

Walmer Lodge is a residential care home providing personal care for up to 12 people with mental health needs, as well as people with a learning disability and/or autism. At the time of the inspection there were 9 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Medicines management was not safe as records were not always accurate. There was no system in place to calculate safe staffing levels. Care staff completed all cooking and cleaning tasks which impacted on the time they had to spend with people.

We have made a recommendation that the provider implements a staffing dependency tool and reviews the current staffing levels to ensure people’s needs are met.

People’s independence was promoted and they were supported to access the community safely. There was an ongoing refurbishment plan and people were involved in choosing the décor and furniture. Some people, where required, had positive behaviour support plans which helped staff support individuals and use de-escalation.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: Overall risk management had improved however we identified risks relating to hot water temperatures and unguarded heaters. The manager addressed these during the inspection. People received person centred care. The staff group reflected the diversity of people using the service. Staff interactions with people were friendly, kind and respectful. People’s dignity and privacy was promoted at all times. The environment was clean and staff followed safe infection control procedures.

Right Culture: Quality assurance systems were not effective or robust. Audits had not identified or addressed the areas we found on inspection. Improvements were needed in provider oversight and governance systems. The manager was responsive in taking action to address the issues we raised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 November 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 11 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, dignity and respect and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service remains requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walmer Lodge Residential Home on our website at www.cqc.org.uk

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Walmer Lodge is a residential care home situated in Bradford. The home provides accommodation and personal care for up to 12 people with complex needs aged 18 to 65. At the time of this inspection there were 11 people living at the home.

People’s experience of using this service and what we found

Systems to monitor and check the service were in place but these needed to be more thorough to ensure the service consistently met the required standards. Improvements were needed in the management of the premises including fire checks. The environment was generally tired and in need of refurbishment.

People who used the service were generally happy with the care and support. People and relatives told us the service was caring and staffing levels were appropriate. However, we observed some practises which showed a lack of respect and were not person centred.

People said they felt safe. Staff had received safeguarding training and had an understanding about how to report abuse. Some people's finances were managed by the provider. We requested additional information about this. We did not receive this, so we could not be assured people's finances were managed safely.

Staff were knowledgeable and received a range of training and regular supervision and appraisal. They said they felt supported in their roles.

Medicines were generally managed safely. There were positive links with healthcare professionals and other agencies to ensure people’s health needs were met and changes responded to promptly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation about improving documentation.

People, relatives and staff said the registered manager and manager were approachable. People’s views were sought through meetings and surveys.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 2 June 2018). Since this rating was awarded the registered provider has altered its legal entity. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to governance and audit procedures and safety. We also identified people were not always treated with dignity and respect.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.